KYEM Form 465 Cumulative Equipment Inventory



|KENTUCKY DIVISION OF EMERGENCY MANAGEMENT |

|RESCUE SQUAD CUMULATIVE EQUIPMENT INVENTORY |

| |

|INSTRUCTIONS: |

| |

|All Minimum Equipment Inventory forms shall be fully completed. Indicate on the blank line beside each equipment item description the actual number of items |

|currently owned by a rescue squad. (i.e., if a rescue squad owns two (2) center punches, enter the number “2” on the blank line. Do not use a check mark to |

|indicate ownership of the equipment item.) Account for all equipment owned by a rescue squad, including items not in working order or no longer serviceable. |

| |

|When a rescue squad engages in more than one specialized rescue squad activity or general rescue squad activity, the equipment listed as New or Replacement |

|Equipment or Replacement Only Equipment for rescue squads specializing in water rescue and recovery, water rescue and recovery utilizing divers, high angle rescue,|

|cave rescue, or search for lost, trapped or missing persons, will not have to be duplicated to meet minimum equipment inventory requirements. Duplicate items |

|listed under specialized rescue squad inventories should be marked with a “D” on the blank line. |

| |

|Direct questions regarding the inventory process to the Kentucky Division of Emergency Management (KyEM) Area Office. |

|GENERAL PURPOSE RESCUE SQUAD MINIMUM EQUIPMENT INVENTORY |

|Protective Gear: | | | |Communications Equipment: |

| | |(12)| | |(1) | |

| | |pair| | |pair| |

| | |s of| | |of | |

| | |glov| | |mini| |

| | |es | | |mum | |

| | | | | |of | |

| | | | | |8” | |

| | | | | |tin | |

| | |(2) first aid kits, 24 unit | | |(1) pair of 36” bolt cutters | |

| | | | | |(2) | |

| | |webb| | |½”x1| |

| | |ing | | |2” | |

| | | | | |goos| |

| | | | | |enec| |

| | | | | |k | |

| | | | | |wrec| |

| | | | | |king| |

| | |(1) 12’ tow chain |

|KENTUCKY DIVISION OF EMERGENCY MANAGEMENT |

|RESCUE SQUAD CUMULATIVE EQUIPMENT INVENTORY |

|SPECIALITY: WATER RESCUE AND RECOVERY SQUAD MINIMUM EQUIPMENT INVENTORY |

| | | |

| | |(1) vehicle dedicated to water |

|SPECIALITY: DIVE RESCUE AND RECOVERY SQUAD MINIMUM EQUIPMENT INVENTORY |

| | | |

| | |(2) extra tanks per certified |

|SPECIALITY: CAVE RESCUE SQUAD MINIMUM EQUIPMENT INVENTORY |

| | | |

| | |(1) vehicle dedicated to cave |

|KENTUCKY DIVISION OF EMERGENCY MANAGEMENT |

|RESCUE SQUAD CUMULATIVE EQUIPMENT INVENTORY |

|SPECIALITY: HIGH ANGLE RESCUE SQUAD MINIMUM EQUIPMENT INVENTORY |

| | | |

| | |(1) vehicle dedicated to high |

|SPECIALITY: SEARCH DOG RESCUE SQUAD MINIMUM EQUIPMENT INVENTORY - PER PERSON |

| | | |

| | |(1) rescue vest |

|SPECIALITY: LOST, TRAPPED OR MISSING SEARCH AND RESCUE SQUAD MINIMUM EQUIPMENT INVENTORY |

| | | |

| | |(1) vehicle dedicated to search |

|PRIMARY RESCUE VEHICLE IDENTIFICATION |

|Unit 1: |

| |

|Make: |

|Make: |

|Make: |

|Make: |

|Make: |

|KENTUCKY DIVISION OF EMERGENCY MANAGEMENT |

|RESCUE SQUAD CUMULATIVE EQUIPMENT INVENTORY |

|ADDITIONAL RESCUE SQUAD EQUIPMENT INVENTORY |

|List all additional rescue equipment owned by a rescue squad. (Use additional pages if needed.) |

|QUANTITY |DESCRIPTION OF EQUIPMENT ITEM |PURCHASED WITH |KY EM ASSIGNED SERIAL |

| | |RESCUE AID FUNDS? |NUMBER |

| | |(Y/N) |(IF APPLICABLE) |

| | | | |

| | | | |

| | | | |

| | | | |

| | | | |

| | | | |

| | | | |

| | | | |

| | | | |

| | | | |

| | | | |

| | | | |

| | | | |

| | | | |

| | | | |

| | | | |

| | | | |

| | | | |

| | | | |

| | | | |

| | | | |

| | | | |

| | | | |

| | | | |

|EQUIPMENT INVENTORY CERTIFICATION |

|I hereby certify that all equipment inventories are a true reflection and accurate statement of all equipment owned by the |

| |

|__________________________________________________________________ as of . |

|NAME OF RESCUE SQUAD DATE |

| |

|Inventory certified by:_________________________________________________ __________________________ |

|SIGNATURE OF LOCAL EM DIRECTOR DATE SIGNED |

|ATTACH A COMPLETED COPY OF ALL INVENTORY PAGES TO EACH RESCUE AID APPLICATION SUBMITTED. |

| |

|COPIES OF PREVIOUSLY CONDUCTED INVENTORIES WILL NOT BE ACCEPTED. |

-----------------------

NOTE: The requirement for encoder, base station radio with antenna and base station tower may be deleted if the rescue squad is dispatched by another agency, city or county public safety communications center.

................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download